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Biographical disruption following traumatic brain injury and experienced transition returning to work
No full textMaster i rehabilitering og habiliteringFormål: Å bidra med kunnskap om hvordan mennesker som har fått en mild traumatisk hodeskade erfarte og opplevde prosessen tilbake til arbeid. En stor andel av dem som opplever en traumatisk hodeskade er i arbeidsfør alder, og arbeidsdeltakelse er en viktig målsetting for rehabiliteringen. Det å være i arbeid er viktig for både selvet, sosial interaksjon, livskvalitet og økonomi.
Metode: Det ble gjennomført individuelle intervjuer med fire kvinner og to menn (29-61 år). Intervjuene ble analysert med bruk av stegvis-deduktiv induktiv metode (SDI).
Resultater: Oppstarten i arbeidet ble referert til som å «stå i det». Informantene beskrev en opplevd krise, viktigheten av å ta valget om å starte og betydningen av tilstedeværelse på arbeidsplassen. Opptrappingsfasen uttrykkes som en «berg-og-dal-bane» med en endret opplevelse av tid og en redusert kapasitet, samt viktigheten av å bli sett og verdsatt på arbeidsplassen. Gjenintegrert i arbeidet ble sitert som «tilbake – med enkelte planer lagt på hyllen», og informantene formidlet at erfaringene hadde ført til endrede prioriteringer og planer.
Konklusjon: Arbeidsdeltakelse betraktes som viktig for strukturering og oppfattelse av tid. Det er tidkrevende å orientere seg i en ny situasjon, få erfaring med egen mestring og skape balanse i hverdagen. Det er viktig å legge til rette for sosial interaksjon og bruk av sosiale ferdigheter i oppgaveutførelsen på arbeidsplassen. Arbeidssituasjonen er ikke umiddelbart synlig og observerbar for omgivelsene og den enkeltes opplevelse av nåværende og fremtidig arbeidsevne er betydningsfull i prosessen tilbake til arbeid. En viktig følelse i arbeidsdeltakelsen oppstod gjennom engasjement i sosiale relasjoner, lik «å gjøre», som førte til trivsel og selvfølelse, lik å «være». Det som utføres i arbeidet, og dets innflytelse på selvfølelsen vil sammen påvirke prosessens endring og utvikling. I et utviklingsperspektiv vil denne prosessen fortsette, og en slik prosess endrer fokus etter hvert som man beveger seg gjennom den.Purpose: To contribute knowledge about lived experiences regarding return to work following mild traumatic brain injury. Most brain injuries occur in people of working age, and employment participation is a key rehabilitation goal. Employment participation is important for self, social interaction, quality of life and economy.
Methods: Individual interviews were conducted with four women and two men (aged 29–61) and analysed using a stepwise-deductive inductive method.
Result: When starting the process of returning to work, referred to as “hang in there”, the informants described an experienced crisis, the importance of making the decision to return, and the value of being present at work. In the process, expressed as a “roller coaster”, they expressed having reduced capacity and a changed perception of time. To be seen and valued at the workplace was significant. Reintegrated at workplace was cited as “back – with some plans put aside”, the newly acquired knowledge led to some changed priorities and plans for further work.
Conclusions: Work participation is important for structure and time perception. It is time-consuming to orient in a new situation, gain experience with own proficiency and create balance in daily life. Facilitating social interaction and the use of social skills in task performance is important. A sense of being through occupational engagement arose in social relationships and self-exploration that enhanced feelings of self-worth. Occupation includes what has been done, and its influence on self-worth will together affect the process's change and development. From a developmental perspective, the process of development in adapting to the new work situation will continue, and focus will change as the individual moves through the process.publishedVersio
Return to work after traumatic brain injury: A randomised controlled trial, long-term employment probability and predictors of employment status
No full textThe aims of this thesis were to investigate: 1) the feasibility of delivering a compensatory cognitive rehabilitation intervention to individuals with mild and moderate TBI in Norway, 2) the effectiveness of a combined cognitive and vocational intervention compared to treatment as usual on employment outcomes after mild and moderate TBI, and 3) long-term employment probability and associated predictors up to 10 years after moderate and severe TBI.
The compensatory cognitive intervention was found feasible in a Norwegian civilian sample with TBI. Compared to those who received treatment as usual, a larger proportion of individuals who received the combined intervention had returned to work 3 months following study inclusion. Employment probability remained stable up to a decade after moderate and severe TBI, and could be predicted by injury severity and specific sociodemographic characteristics.
The findings demonstrate that interventions which include collaboration between healthcare and employment services may positively influence employment outcomes after TBI. The importance of providing regular follow-up to individuals at-risk of long-term unemployment after TBI is underlined
New Perspectives in Rehabilitation after Traumatic Brain Injury
Get PDFThere has been increased focus on evaluating the scientific knowledge base within the field of traumatic brain injury (TBI) rehabilitation. TBI rehabilitation comprises several phases, from acute medical care to post-acute care in rehabilitation facilities and chronic care in the community. Rehabilitation is a multidisciplinary effort that covers the full spectrum of medical neuroscience, cognitive neuroscience, pharmacology, brain imaging, and assistive and smart technology. A future challenge is to integrate these areas to guide TBI rehabilitation into extensive research and clinical practice. The use of smart technologies and improved brain imaging techniques has an important future in the rehabilitation of patients with cognitive difficulties and disabilities. There is also the need for broad international collaboration to establish large multinational clinical trials in order to define effective service provision and to reach a consensus on the best evidence-based practice of TBI rehabilitation. With this Special Issue, we hope to encourage submissions that discuss ongoing knowledge gaps and controversies, and focus on new perspectives regarding the rehabilitation and management of TBI
Rehabilitation and outcomes after complicated vs uncomplicated mild TBI: results from the CENTER-TBI study
No full textAbstract Background Despite existing guidelines for managing mild traumatic brain injury (mTBI), evidence-based treatments are still scarce and large-scale studies on the provision and impact of specific rehabilitation services are needed. This study aimed to describe the provision of rehabilitation to patients after complicated and uncomplicated mTBI and investigate factors associated with functional outcome, symptom burden, and TBI-specific health-related quality of life (HRQOL) up to six months after injury. Methods Patients ( n = 1379) with mTBI from the Collaborative European NeuroTrauma Effectiveness Research in TBI (CENTER-TBI) study who reported whether they received rehabilitation services during the first six months post-injury and who participated in outcome assessments were included. Functional outcome was measured with the Glasgow Outcome Scale – Extended (GOSE), symptom burden with the Rivermead Post Concussion Symptoms Questionnaire (RPQ), and HRQOL with the Quality of Life after Brain Injury – Overall Scale (QOLIBRI-OS). We examined whether transition of care (TOC) pathways, receiving rehabilitation services, sociodemographic (incl. geographic), premorbid, and injury-related factors were associated with outcomes using regression models. For easy comparison, we estimated ordinal regression models for all outcomes where the scores were classified based on quantiles. Results Overall, 43% of patients with complicated and 20% with uncomplicated mTBI reported receiving rehabilitation services, primarily in physical and cognitive domains. Patients with complicated mTBI had lower functional level, higher symptom burden, and lower HRQOL compared to uncomplicated mTBI. Rehabilitation services at three or six months and a higher number of TOC were associated with unfavorable outcomes in all models, in addition to pre-morbid psychiatric problems. Being male and having more than 13 years of education was associated with more favorable outcomes. Sustaining major trauma was associated with unfavorable GOSE outcome, whereas living in Southern and Eastern European regions was associated with lower HRQOL. Conclusions Patients with complicated mTBI reported more unfavorable outcomes and received rehabilitation services more frequently. Receiving rehabilitation services and higher number of care transitions were indicators of injury severity and associated with unfavorable outcomes. The findings should be interpreted carefully and validated in future studies as we applied a novel analytic approach. Trial registration ClinicalTrials.gov NCT02210221
Going Beyond Counting First Authors in Author Co-citation Analysis
Get PDFThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Get PDF“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Get PDFWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Dispelling the Myths Behind First-author Citation Counts
Get PDFWe conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued
use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation
counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more
sophisticated methods
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